Morton’s neuroma

Does anyone here have experience dealing with a Morton’s neuroma? Was just diagnosed with one in each foot between my second and third metatarsals. I found a thread from over a decade ago, but there wasn’t a lot of advice on how to manage them long term besides with surgery.

I’m planning to get some shoes with a wider toe box and maybe try wearing socks with them so I can tape a metatarsal pad on each foot. Would love advice from other climbers who have dealt with these. 

Rosalie I wrote:

Does anyone here have experience dealing with a Morton’s neuroma? Was just diagnosed with one in each foot between my second and third metatarsals. I found a thread from over a decade ago, but there wasn’t a lot of advice on how to manage them long term besides with surgery.

I’m planning to get some shoes with a wider toe box and maybe try wearing socks with them so I can tape a metatarsal pad on each foot. Would love advice from other climbers who have dealt with these. 

I have had it for many years. Strengthening your feet and toes are key. Wear very wide toe box shoes such as Altras. Get some toe spacers and work on toe strengthening exercises. A good PT or Chiro familiar with the condition should be able to help you a lot. A custom set of insoles with a pad under the forefoot may help and in bad flare ups, a cortisone shot and nsaids can reduce the inflammation. 

Cam Brown wrote:

I have had it for many years. Strengthening your feet and toes are key. Wear very wide toe box shoes such as Altras. Get some toe spacers and work on toe strengthening exercises. A good PT or Chiro familiar with the condition should be able to help you a lot. A custom set of insoles with a pad under the forefoot may help and in bad flare ups, a cortisone shot and nsaids can reduce the inflammation. 

^ My partner has it and does all of the above and this, using Melt Method balls, which are a certain softness:

I fought a Mortons neuroma for 4 years, trying everything under the sun. I eventually had the Pod Surgeon cut it out and I wish I had done that at the end of a year of trying other methods. Missed out on 3 years of climbing hoping that I could get it to relent- trying PRP therapy, spacers, 3 different PTs. $800 worth of laser scanned custom orthotics… and on and on.  

Try all the things for sure. Keep in mind that the nature of living life as a biped while getting healing to occur in feet is not always easy. Gotta have patience. 

I’ve had Morton’s Neuroma for a few years.  On the advice of an Orthopedist, I bought 4E width shoes for everything except climbing (hiking, running, dress shoes etc) and I virtually never go barefoot. I also put thin sized Sole brand Meta Pad insoles in every pair of shoes I own.  I wear Crocs around the house, they are very wide and well cushioned.  The key is to have almost zero restriction for your forefoot to spread. It took a month or two but the inflammation and pain totally disappeared.  If I go on long alpine hikes, the descent seems to still aggravate those metatarsal nerves, but that’s pretty much the only symptoms I still have.  And I have to be careful not to wear my climbing shoes for too long, taking them off between climbs. I have a pair of very loose shoes for multi pitches. 

Thanks for all the replies! I’m seeing an osteopath tomorrow who’s been climbing for decades, so I’m hoping he’ll have some helpful advice.
Is there a certain type or brand of toe spacers that work better than others? That’s a bummer about wearing shoes all the time. I love being barefoot. 

Andy, how much sensitivity did you lose in your toes for rock climbing after the surgery?

I've struggled with this condition for years, and my feet are a mess. . bunions, hammer toes and morton's. I live in pain of various levels most of the time. My big toes has basically pushed my second toe out of alignment, and it is really tough to wear my alpine boots for an entire day. I really wish there was a solution, because I'm an old guy in good shape, but this is my most vulnerable part of my body and it's affecting my climbing. 

Brad White wrote:

Andy, how much sensitivity did you lose in your toes for rock climbing after the surgery?

In my case, the neuroma was atypical, in the first digit (big toe).  The nerve that was inflamed was only sensory, innervating the space between the great toe and second digit, mostly the bottom of the foot.  I had total numbness in this small V-shaped area for about 2-3 months.  Now, 15 months later I can barely tell anything was ever numb, just the scar on the top of my foot to remind me.  The other nerves in the area (for some people) will sort of restore sensation in the lost area.

I was VERY apprehensive about this numbness, especially being the big toe I was worried about balance on the ground and dexterity on the wall.  That's one of the reasons I tried so many less invasive treatments.  But the numbness for me had essentially zero impact on my climbing, on walking over tricky talus, on yoga practice, etc.  I was worried about getting blisters inbetween the first and second digit, not being able to feel the hotspot.  But the sensation returned and I have not had any issues.

I'm all about being on the alert for " lazy western medicine", quick to prescribe pharmas, tests, injections and surgery, in response to the American propensity for instant gratification and effort free solutions.  But in this case, I really regret being almost entirely unable to climb from age 29-32 while trying to get that f'er at the base of my big toe to calm down. I have few regrets in life, but this one makes the list.

I have been sidelined for a few weeks by a mortons. It is most definitely caused by the moderate bunion I have developed. Good call getting an appointment set up with a professional. I have followed their advise and have had successful results with conservative treatment thus far. 

As far as spacers I am basically ALWAYS using some type of GEL spacer when I'm wearing shoes or boots. This includes climbing shoes. In the evening I use the full toe box spacers. Aging is a brutal process...

These are great for lounging in the evening.

Type of spacer I use when wearing shoes/boots. More of a bunion thing.

I have been an avid climber and runner for the last 10 years. Similar to others I tried to deal with it naturally and ultimately had the surgery. My advice is to get the surgery. You won’t regret it. I still get flare ups of nerve damage if I step on a rock or run on the pavement but life is so much better post surgery. 

I have been an avid climber and runner for the last 10 years. Similar to others I tried to deal with it naturally and ultimately had the surgery. My advice is to get the surgery. You won’t regret it. I still get flare ups of nerve damage if I step on a rock or run on the pavement but life is so much better post surgery. 

Hi everyone,

I'm dealing with Morton's neuroma and looking for advice from fellow climbers on using metatarsal pads for each foot. If you have experience with this, I'd love to hear about the following:

1. What type of metatarsal pads have worked best for you?
2. How do you position the pads in your climbing shoes?
3. Any tips on adjusting to climbing with the pads?
4. Have you found any specific climbing shoes that accommodate the pads well?

Thanks in advance for your help!

Hi folks. I just came back on MP after a long time away to ask about people's experiences with Morton's Neuroma. Then I found this thread! I've had a painful one for the last year and have resisted getting a neurectomy because of the potential for a stump neuroma to form. I'm in a Facebook group called, "Support for Morton's Neuroma Pain". Numerous folks in that group, including a well know Podiatrist in Las Vegas, Dr Bregman, believe that before having a Neurectomy, you should get a Decompression. That's where they cut the Deep Transverse Metatarsal Ligament (DTML), over the Neuroma to allow the foot to spread more, giving the Neuroma more room. Both my Podiatrist and my Orthopod have said that cutting the ligament will cause destabilization of the foot, and they recommend cutting the nerve out. Dr Bregman has said destabilization is NOT an issue, and in fact, when you have a Neurectomy, the DTML has to be cut anyways to allow access to the Neuroma. I live in Reno, and I'm going to see Dr Bregman in the next week or so for a consultation. Can any of you who've had the Neurectomy experienced any destabilization?

Addressing the OP's questions; Once the Neuroma gets to a certain size, all the less invasive measures become less effective. I've bought wider shoes, custom orthotic footbeds, metatarsal pads, ( 1/4 inch thick), and while they do help, they are a stopgap measure at this point for me. Thanks for starting this thread Rosalie!

My story. I have been climbing since the age of 16 (I'm 75 now). In 2015 I started to have somewhat sharp pain (like having a stone in my shoe) in my right foot. The pain was between the third and fourth toe. It wasn't too bad while climbing, but hiking a few miles really hurt.

In 2018 I finally went to see a foot doctor. Was diagnosed with Morton's Neuroma. The nerve was about 3/4 inch long and pressing on the two toes. Over the next few months I was given couple shots into the area. That didn't help much.  UCSD finally cut the nerve out in 2019. 

The toes today (5 years later) are a bit numb and occasionally I have a slight discomfort in the area after a long hike. But if I had to do it again, I would have it cut out rather than suffer years of  discomfort. I agree with Glen Prior above. Once the Neuroma gets to a certain size, surgery might be the only answer.

Update on my neuromas and the treatments that have/haven't worked:

I initially saw a podiatrist who gave me a steroid injection in each second/third metatarsal space, advised me to stop climbing, wrote me a prescription for meloxicam (NSAID), and recommended custom orthotics. My insurance wouldn't cover the orthotics and I didn't want to pay $600 for a pair, so I tried metatarsal pads instead. After wearing those for a few weeks, I developed neuromas in my third/fourth metatarsal space. I guess the way it spread my 2nd/3rd space put pressure on the 3rd/4th nerve. Went back to the podiatrist and got those injected too. 

After about a month without any improvement in pain, I went to an osteopath I know from the climbing gym. He told me that steroid injections were for acute injections, so the one they gave me for my original neuromas were basically useless since I'd been having pain for 6 months before they got injected. He advised strengthening my foot, especially my big toe, finding climbing shoes with a wider toe box, stepping down the difficultly in of my climbs (yay! I could still climb!), taking my shoes off between climbs, and trying to go barefoot as much as possible (which I prefer to do anyway). Did some manipulations on my foot and gave me pt exercises to do. Several weeks later, my symptoms had significantly improved. 

I had a few months with only some pain, but any time I hiked more than a mile or two, the neuromas would flare back up. I did many approaches barefoot because that felt better than wearing hiking boots. 

In September, I went on a month-long climbing trip. I got steroid injections in all four neuromas before the trip. There were some places I was able to hike barefoot, but some I couldn't. I had success KT taping between my toes and around the arch of my foot to spread my toes and keep pressure off my nerves, but was still limited in what I could do. There were many climbs when I took off one of my shoes halfway up because of the pain and finished the climb that way. I also had to stop taking NSAIDs because I developed a stomach ulcer from them. Not a fun way to lose 25 pounds. 

At some point on the trip, I thought to look up foot yoga to see if it would help with the pain. I had almost instant relief. I started doing this 10 minute routine before and after climbing, which has helped tremendously. By the end of the trip, my feet were almost pain free. 

Unfortunately, my job requires me to be on my feet all day and to stand in weird positions (I'm a surgical assistant). Within a week of returning to work, my neuromas flared up again. It's very likely that my job is why my neuromas haven't healed yet. Maybe I should have bit the bullet and bought the custom orthotics to wear at work. I didn't want to spend the money, so I taped my feet every day and slipped off my shoes whenever possible. Sometime in December I tried botox injections. It took a few weeks to kick in, but between that and getting arch supporting inserts, my feet have felt the best they have in a year and a half. I still have days where it's painful to climb, but I haven't had to tape my feet or rip off a shoe mid climb from the pain. I'm hopeful I can continue healing and avoid surgery. 

Thanks every who responded on this thread! It's helpful getting perspective from other climbers. 

I had one in the early 80’s and steroid shots and wide shoes didn’t work so I had it removed with no ill effects on climbing or walking. If that was the only thing that has given me issues with that foot it would be great   

I would have had to quit climbing if I didn't get the surgery. Fairly quick recovery, and 10+ years later haven't had any problems hiking or climbing since then.